title: Renal sympathetic nerve ablation for treatment-resistant hypertension.
abstract: Hypertension is a major risk factor for increased cardiovascular events with accelerated sympathetic nerve activity implicated in the pathogenesis and progression of disease. Blood pressure is not adequately controlled in many patients, despite the availability of effective pharmacotherapy. Novel procedure- as well as device-based strategies, such as percutaneous renal sympathetic nerve denervation, have been developed to improve blood pressure in these refractory patients. Renal sympathetic denervation not only reduces blood pressure but also renal as well as systemic sympathetic nerve activity in such patients. The reduction in blood pressure appears to be sustained over 3 years after the procedure, which suggests absence of re-innervation of renal sympathetic nerves. Safety appears to be adequate. This approach may also have potential in other disorders associated with enhanced sympathetic nerve activity such as congestive heart failure, chronic kidney disease and metabolic syndrome. This review will focus on the current status of percutaneous renal sympathetic nerve denervation, clinical efficacy and safety outcomes and prospects beyond refractory hypertension.
authors.affiliation: Centre of Cardiovascular Research & Education (CCRE) in Therapeutics, Monash University/Alfred Hospital, Melbourne, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
authors.forename: Markus
authors.initials: M
authors.lastname: Schlaich
authors.forename: Paul
authors.initials: P
authors.lastname: Sobotka
mesh_terms: D000344:Afferent Pathways / Q000601:surgery; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017115:Catheter Ablation / Q000379:methods*; D004351:Drug Resistance; D004525:Efferent Pathways / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: denervation; hypertension; renal